title: Presence of paraneoplastic antibodies in non-carcinomatous patients with neurological involvements of unknown cause.
abstract: BACKGROUND
  Paraneoplastic antibodies (PAs) play a crucial role in the diagnostic approach of paraneoplastic neurological syndrome (PNS). We clarified the frequency and the clinical profile of PA-positive non-carcinomatous patients with neurological involvements of unknown cause.
  
  
  METHODS
  PAs were analyzed in sera of 222 consecutive non-carcinomatous patients (122 men and 100 women) defined as acute or subacute onset of unknown-causative symptoms involving the neuromuscular junction, the central and/or the peripheral nervous system between 2006 and 2009. PAs contained antineuronal nuclear autoantibody type 1, 2, 3, Purkinje cell cytoplasmic autoantibody type 1, 2, anti-Tr, amphiphysin, CRMP-5, P/Q-type, N-type voltage-gated calcium channels (VGCC), voltage-gated potassium channel complex (VGKCC) and neuronal acetylcholine receptor (nAChR) antibodies. PA-seropositive patients received detailed examination of carcinoma in the whole body for the following 2 years.
  
  
  RESULTS
  Nine patients were PA-positive. VGKCC antibodies were found in four patients, P/Q-type VGCC antibodies in two, N-type VGCC antibodies in two and nAChR antibodies in one. Neurological features revealed limbic encephalitis in four patients, sensorimotor neuropathy in three and Lambert-Eaton myasthenic syndrome in two. One year later, 2 patients developed myelodysplastic syndrome and lung adenocarcinoma (one patient each).
  
  
  CONCLUSIONS
  We conclude that PA-seropositive frequency is 4.1% in non-carcinomatous neurological patients at examination. VGKCC, P/Q-type and N-type VGCC, and nAChR antibodies have benefits for screening non-carcinomatous PNS patients with acute or subacute neurological deficits of unknown cause.
authors.affiliation: Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Yanagihashi
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Kawabe
authors.forename: Ken
authors.initials: K
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D020864:Calcium Channels, N-Type / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000150:complications; D009687:Nuclear Proteins / Q000276:immunology*; D010257:Paraneoplastic Syndromes / Q000097:blood / Q000150:complications / Q000276:immunology; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology*; D012189:Retrospective Studies
chemical_list: D001323:Autoantibodies; D020864:Calcium Channels, N-Type; D009687:Nuclear Proteins; D024642:Potassium Channels, Voltage-Gated
keywords: Neurological profile; Neuronal acetylcholine receptor; Non-carcinoma; Paraneoplastic antibodies; Voltage-gated calcium channels; Voltage-gated potassium channel complex